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  • 1.
    Dahlqvist, Vera
    et al.
    Umeå University, Faculty of Medicine, Nursing.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Glasberg, Ann-Louise
    Umeå University, Faculty of Medicine, Nursing.
    Lindahl, Elisabeth
    Umeå University, Faculty of Medicine, Nursing.
    Lützén, Kim
    Strandberg, Gunilla
    Umeå University, Faculty of Medicine, Nursing.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Nursing.
    Sørlie, Venke
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Nursing.
    Development of the perceptions of conscience questionnaire.2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 2, p. 181-193Article in journal (Refereed)
    Abstract [en]

    Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses' assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers.

  • 2.
    Dahlqvist, Vera
    et al.
    Umeå University, Faculty of Medicine, Omvårdnad.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Omvårdnad.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Omvårdnad.
    Dealing with stress: Patterns of self-comfort among healthcare students.2008In: Nurse Education Today, ISSN 0260-6917, Vol. 28, no 4, p. 476-584Article in journal (Refereed)
  • 3.
    Dahlqvist, Vera
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Facing inadequacy and being good enough: psychiatric care providers' narratives about experiencing and coping with troubled conscience2009In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 16, no 3, p. 242-247Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to illuminate the meaning of encounters with a troubled conscience among psychiatric therapists. Psychiatric care involves ethical dilemmas which may affect conscience. Conscience relates to keeping or losing a sense of personal integrity when making judgments about one's actions. Ten psychiatric therapists were interviewed in June 2006. The interviews were tape-recorded, transcribed verbatim and interpreted using a phenomenological-hermeneutic method. Two themes 'Facing inadequacy' and 'Struggling to view oneself as being 'good enough'' are presented. In the therapists interviewed, awareness of their use of power, a sense of powerlessness and a sense of blame gave rise to feelings of betrayals and shameful inadequacy. By sharing their inadequacy with co-workers, they managed to endure the sense of their inadequacy which otherwise would have threatened to paralyse them. Finding consolation in sharing wearing feelings, becoming realistic and attesting their worthiness, they reached reconciliation and found confirmation of being good enough. The findings are interpreted in light of Lögstrup's ethics of trust, according to which conscience alerts us to silent but radical ethical demand and the risk of self-deception.

  • 4. Eldh, Ann Catrine
    et al.
    Vogel, Gisela
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Blomqvist, Hans
    Wengstrom, Yvonne
    Use of Evidence in Clinical Guidelines and Everyday Practice for Mechanical Ventilation in Swedish Intensive Care Units2013In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 10, no 4, p. 198-207Article in journal (Refereed)
    Abstract [en]

    Background and Aim: One way to support evidence-based decisions in health care is by clinical guidelines, in particular, in highly specialized care such as intensive care units (ICUs). The aim of this study was to explore the development and dissemination of guidelines regarding mechanical ventilation (MV) in Swedish ICUs, and the use of evidence on MV in guidelines and everyday practice.

    Methods: Inviting all general ICUs in Sweden (N = 65), a national survey was performed on occurrence of MV guidelines, and a review of submitted ICU guidelines by four evidence items from the AGREE instrument. In addition, ICU head nurses and senior physicians were interviewed using semistructured and open-ended questions to explore development and dissemination of MV guidelines, staff adherence or nonadherence to guidelines, and everyday practice of MV management bedside.

    Findings: Fifty-five ICUs (85%) participated in the study; 51 ICUs submitted a total of 245 guidelines, including recommendations for medical or nursing MV actions. None of the documents included how evidence had been sought or assessed, while 22% included a list of references (n = 54). No guidelines included patients' experiences of MV. According to the managers, the guidelines were most often compiled by a multiprofessional team sharing the information through the ICU's website. The guidelines were mainly used as a basis for MV management bedside, but variation occurred as a result of personal preferences, lack of awareness, and adjustment to patients' needs.

    Conclusions: Local MV guidelines seem to constitute a basis for healthcare practice in Swedish ICUs, even though the evidence proposed was limited with respect to how it was attained and lacked patient perspectives. In addition, the strategies used for dissemination were limited, suggesting that further initiatives are needed to support knowledge translation in advanced healthcare environments such as ICUs.

  • 5.
    Fischer Grönlund, Catarina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlqvist, Vera
    Umeå University, Faculty of Medicine, Department of Nursing. Ersta Skondal University College, Department of Health Care Sciences, Stockholm, Sweden.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience.2011In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 12, article id 8Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: This study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection. The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care.

    METHOD: A phenomenological hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology.

    RESULTS: The analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made.

    CONCLUSION: The meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience into using conscience as a guide - in situations where no way of solving the problem seems to be good.

  • 6.
    Fischer Grönlund, Catarina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlqvist, Vera
    Zingmark, Karin
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Managing Ethical Difficulties in Healthcare: Communicating in Inter-professional Clinical Ethics Support Sessions2016In: HEC Forum, ISSN 0956-2737, E-ISSN 1572-8498, Vol. 28, no 4, p. 321-338Article in journal (Refereed)
    Abstract [en]

    Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support (CES) inspired by Habermas' theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved.

  • 7.
    Fischer Grönlund, Catarina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlqvist, Vera
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Towards a method for clinical ethics support to promote inter-professional communication about ethically difficult care situations: observations of an interventionManuscript (preprint) (Other academic)
    Abstract [en]

    Background Studies show that healthcare professionals need inter-professional clinical ethics support (CES) to communicate and reflect on ethically difficult care situations. Internationally, various CES-interventions have been performed, but the communication process and the organisation of CES are sparsely described in the literature. The CES intervention observed in this study was inspired by Habermas’ theory of communicative action and involved healthcare professionals meeting inter-professionally to discuss value conflicts to achieve a common understanding and arrive in agreement about how to act and relate. The communication of value conflicts during a series of sessions in this CES - intervention has been described in a previous study. To further develop a clearly described theory-based CES-method it is important to increase knowledge about the conditions that can promote communication of value conflicts. The aim of this study was therefore to explore the organisational and communicative conditions of a CES intervention with the intention to promote interprofessional communication about ethically difficult care situations.

    Methods Eight audio- and video-recorded CES sessions were conducted over a period of eight months. The observations were transcribed and sorted by using the video analysis tool Transana and analyzed with concept and data-driven content analysis methods.

    Results The findings show the CES organization as an integrated framework, providing both a given structure and openness for variation, as conditions for facilitating the communication of value conflicts. The structure consisted of both constancy and flexibility. The given structure provided constancy while the openness for variation provided flexibility. The combination of constancy and flexibility generated bot safety, and stability for a free and dynamic dialogue, and opened up for responsiveness and creativity to find proposals for actions. As courses of actions to reach communicative agreement were the approaches of a permissive communication, extended views and mutual understanding found.

    Conclusion The results showed CES as an integrated framework with a given structure and openness for variations as conditions to reach a communicative agreement. The findings constitute a step towards a clearly described CES method based on Habermas theory of communicative action. Extended intervention studies with different kinds of data needs to be conducted in order to fully develop the method and get increased knowledge about how to promote a dialogue about ethically difficulties.

  • 8.
    Fischer Grönlund, Catarina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Zingmark, Karin
    County Council of BD, Sweden.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Dahlqvist, Vera
    Ethically difficult situations in hemodialysis care: nurses' narratives2015In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 22, no 6, p. 711-722Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Providing nursing care for patients with end-stage renal disease entails dealing with existential issues which may sometimes lead not only to ethical problems but also conflicts within the team. A previous study shows that physicians felt irresolute, torn and unconfirmed when ethical dilemmas arose.

    RESEARCH QUESTION: This study, conducted in the same dialysis care unit, aimed to illuminate registered nurses' experiences of being in ethically difficult situations that give rise to a troubled conscience.

    RESEARCH DESIGN: This study has a phenomenological hermeneutic approach.

    PARTICIPANTS: Narrative interviews were carried out with 10 registered nurses working in dialysis care.

    ETHICAL CONSIDERATIONS: The study was approved by the Ethics Committee of the Faculty of Medicine, Umeå University.

    RESULTS: One theme, 'Calling for a deliberative dialogue', and six sub-themes emerged: 'Dealing with patients' ambiguity', 'Responding to patients' reluctance', 'Acting against patients' will', 'Acting against one's moral convictions', 'Lacking involvement with patients and relatives' and 'Being trapped in feelings of guilt'.

    DISCUSSION: In ethically difficult situations, the registered nurses tried, but failed, to open up a dialogue with the physicians about ethical concerns and their uncertainty. They felt alone, uncertain and sometimes had to act against their conscience.

    CONCLUSION: In ethical dilemmas, personal and professional integrity is at stake. Mistrusting their own moral integrity may turn professionals from moral actors into victims of circumstances. To counteract such a risk, professionals and patients need to continuously deliberate on their feelings, views and experiences, in an atmosphere of togetherness and trust.

  • 9.
    Forsner, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Högskolan Dalarna.
    Jansson, Lilian
    Umeå University, Faculty of Medicine, Department of Nursing.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Afraid of medical care school-aged children's narratives about medical fear.2009In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 24, no 6, p. 519-528Article in journal (Refereed)
    Abstract [en]

    Fear can be problematic for children who come into contact with medical care. This study aimed to illuminate the meaning of being afraid when in contact with medical care, as narrated by children 7-11 years old. Nine children participated in the study, which applied a phenomenological hermeneutic analysis methodology. The children experienced medical care as "being threatened by a monster," but the possibility of breaking this spell of fear was also mediated. The findings indicate the important role of being emotionally hurt in a child's fear to create, together with the child, an alternate narrative of overcoming this fear.

  • 10.
    Glasberg, Ann-Louise
    et al.
    Umeå University, Faculty of Medicine, Nursing.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Dahlqvist, Vera
    Umeå University, Faculty of Medicine, Nursing.
    Lindahl, Elisabeth
    Umeå University, Faculty of Medicine, Nursing.
    Strandberg, Gunilla
    Umeå University, Faculty of Medicine, Nursing.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Nursing.
    Sørlie, Venke
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Nursing.
    Development and initial validation of the Stress of Conscience Questionnaire2006In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 6, p. 633-648Article in journal (Refereed)
    Abstract [en]

    Stress in health care is affected by moral factors. When people are prevented from doing 'good' they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach's alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: 'internal demands' and 'external demands and restrictions'. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts.

  • 11.
    Glasberg, Ann-Louise
    et al.
    Umeå University, Faculty of Medicine, Omvårdnad.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Omvårdnad.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Omvårdnad.
    Sources of burnout among healthcare employees as perceived by managers.2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 1, p. 10-19Article in journal (Refereed)
  • 12.
    Lindahl, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gilje, Fredricka
    University of Alaska Anchorage, USA.
    Norberg, Astrid
    Ersta Sköndals University College, Sweden.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses' ethical reflections on caring for people with malodorous exuding ulcers2010In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 17, no 6, p. 777-790Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate nurses' reflections on obstacles to and possibilities for providing care as desired by people with malodorous exuding ulcers. Six nurses who took part in a previous study were interviewed. The participants were shown an illustration with findings from a study that elucidated the meaning of living with malodorous exuding ulcers. They were asked to reflect on the obstacles to and possibilities of providing the care desired by the patients. Twelve audio-recorded transcribed interviews were analysed using qualitative content analysis. Our interpretations of participants' reflections on the obstacles and possibilities while caring for such patients revealed one theme: striving to 'do good' and 'be good'. The obstacles were formulated as subthemes: experiencing clinical competence constraints, experiencing organizational constraints, experiencing ineffective communication, fearing failure, and experiencing powerlessness. The possibilities were formulated by the subthemes: spreading knowledge about ulcer treatments, considering wholeness, and creating clear channels of communication. A multiprofessional team could overcome the identified obstacles and provide structure, competencies, commitment and support to 'do good' for patients and 'be good' nurses.

  • 13.
    Lindahl, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Omvårdnad.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Omvårdnad.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Omvårdnad.
    The meaning of caring for people with malodorous exuding ulcers.2008In: Journal of Advanced Nursing, ISSN 1365-2648, Vol. 62, no 2, p. 163-71Article in journal (Refereed)
  • 14.
    Lindahl, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Omvårdnad.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Omvårdnad.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Omvårdnad.
    The meaning of living with malodorous exuding ulcers.2007In: Journal of Nursing and Healthcare of Chronic Illnes in association with Journal of Clinical Nursing, ISSN 0962-1067, Vol. 16, no 3A, p. 68-75Article in journal (Refereed)
  • 15.
    Söderberg, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gilje, F
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dignity in situations of ethical difficulty in intensive care.1997In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 13, no 3, p. 135-44Article in journal (Refereed)
    Abstract [en]

    In intensive care, situations of ethical difficulty are common. For the purpose of illuminating the meaning of being in ethically difficult situations, 20 registered nurses (RNs) employed in six intensive care units in Sweden narrated episodes of ethical difficulty. From a phenomenological hermeneutic perspective, the core theme of 'dignity' was identified in 85 stories. Stories with the concept of dignity reveal a threefold meaning; transforming disrespect into respect for the inviolable value of the human being; transforming ugly situations into beautiful ones; transforming discord of death into togetherness. Stories without the concept of dignity were oriented toward skills and physical care without reflection on actions and a 'taken-for-granted attitude' that good will prevail. Comparing and contrasting stories with and without dignity revealed the demands of dignity: attentiveness, awareness, personal responsibility, engagement, fraternity and active defence of dignity. In light of the philosophies of Weil, Marcel and Ricoeur, the demands of dignity correspond to qualities generated when struggling for respecting the dignity of human beings. This study reveals that dignity begets dignity, which opens the RNs to the ethical dimension. This, in turn, counteracts the risk of dehumanizing care in technocratic environments.

  • 16.
    Söderberg, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gilje, Fredricka
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Transforming desolation into consolation: the meaning of being in situations of ethical difficulty in intensive care.1999In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 6, no 5, p. 357-73Article in journal (Refereed)
    Abstract [en]

    The purpose of this phenomenological-hermeneutic study was to illuminate the meaning of being in ethically difficult care situations. The participants were 20 enrolled nurses employed in six intensive care units in Sweden. The results reveal a complex human process manifested in relation to one's inner self and the other person, which transforms desolation into consolation through becoming present to the suffering other when perceiving fragility rather than tragedy. The main point of significance here is for all health professionals to create an ethical work environment and strive for praxis that fosters 'at-homeness', which renders us free to transform desolation into consolation. Consolation is of significance in ethics because it makes us available and helps us to fulfil the demands of life, while desolation makes us unavailable to others.

  • 17.
    Söderberg, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Intensive care: situations of ethical difficulty.1993In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 18, no 12, p. 2008-14Article in journal (Refereed)
    Abstract [en]

    Twenty enrolled nurses (ENs), 20 registered nurses (RNs) and 20 physicians working in intensive care in northern Sweden narrated 255 stories about their experience of being in ethically difficult care situations. The ENs' stories mainly concerned problems relating to relationship ethics, the stories narrated by the physicians mainly concerned problems relating to action ethics, while the RNs' stories gave equal attention to both kinds of problems. The most common theme of both the RNs' and the physicians' stories was that of too much treatment. An obvious similarity between the ENs, RNs and physicians was that they saw themselves as equally lacking in influence in ethically difficult care situations. The only apparent difference between the three groups, however, was that the ENs brought up relationship problems more often than the others. Thus, the differences between the RNs and the physicians were fewer than usually reported in the literature. This might be related to the specialization of intensive care.

  • 18.
    Söderberg, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gilje, Fredricka
    Meeting tragedy: interviews about situations of ethical difficulty in intensive care.1996In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 12, no 4, p. 207-17Article in journal (Refereed)
    Abstract [en]

    For the purpose of illuminating the meaning of being in ethically difficult situations, eight enrolled nurses, 12 registered nurses and 10 physicians (n = 30) working in intensive care units in Sweden were asked to narrate care episodes of ethical difficulty. A phenomenological-hermeneutical analysis of the 30 narratives about nine care episodes disclosed that all stories concerned meeting tragedy, which evoked a spirit of compassion that pointed to values. The 'intention of compassion' aimed at respecting these ethical values. Respecting ethical values meant being consoled, which generated confidence in life that helped the person to embrace tragedy. When values were not respected, ethical problems emerged. Communication of values facilitated realisation, while unconscious values were indirectly communicated through emotions. Such communication meant risking vulnerability and meeting oneself. Meeting self and one's vulnerability demanded abilities of being consoled, i.e. in this study giving consolation, providing realistic treatment and being faithful in one's profession. A prerequisite for expressing personal standpoints and cooperating in the struggles of respecting ethical values was holding each other in great respect. When meeting tragedy, the spirit of compassion pointed to ethical problems, to the possibilities of solving the problems, and to the fulfilment of vision through converting feelings of despair into action energy.

  • 19.
    Söderholm, Anna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    The experience of living with sensory hyperreactivity: accessibility, financial security, and social relationships2011In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 32, no 8, p. 686-707Article in journal (Refereed)
    Abstract [en]

    Odor intolerance is a frequently reported problem, predominantly among women. Our purpose was to illuminate how individuals living with sensory hyperreactivity (SHR; a form of odor intolerance) experience its impact on accessibility, financial security, and social relationships. Data were collected by having 12 women with SHR write descriptive texts. These texts were analyzed with qualitative content analysis. Six themes were identified: Being limited in participating in society, being forced to behave incompatibly with one’s personality, experiencing lack of understanding and respect from others, experiencing insecurity, being dependent on others, and being forced to choose between the plague and cholera.

  • 20.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Strandberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Nursing.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlqvist, Vera
    Umeå University, Faculty of Medicine, Department of Nursing.
    Parents' experiences of what comforts them when their child is suffering from cancer2010In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 27, no 5, p. 266-275Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe parents' narratives concerning what they find comforting when they have a child suffering from cancer. Interviews were conducted with 9 parents--8 mothers and 1 father--of children aged 3 to 9 years who were admitted to a pediatric oncology ward and had undergone their first treatment. The findings showed that the parents derived comfort from being close to their child, perceiving the child's strength, feeling at home in the ward, being a family and being at home, and receiving support from their social network. Comfort experienced in communion with the child and others became important and helped the parents build a new normality perceived as being at home in life despite all their difficulties. Within the frame of communion, the parents seemed to experience moments of hope for their child's recovery and survival.

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